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Medicare has begun to cover the welcome to medicare physical exam, diabetes screening and cholesterol screening. These are the first preventative measures covered under the program which does cover treatment. The physical is only open t new Medicare enrollees within the first six months of enrollment. The program will allow $139.67 to the physician for the exam. The cholesterol is once every five years and is covered under lab tests. The diabetic screening is only for those having risk factors and is allowed once a year unless the patient has pre-diabetes when it is allowed twice per year. Top
Missouri has agreed that all newborns should be screened for 25 genetic disorders. This is an unfunded mandate on the profession but a needed one. The tests will need to be done in one lab in Jefferson City and will be mandated to be covered by all private and public insurances. The cost to the uninsured will be $50. Top
California has issued proposed regulations for HMO prescription drugs. The regs would insure that all medically necessary drugs would be covered. This comes from a law passed in 2002. The plan would be allowed to delete drugs with no proven benefit, cosmetic proposes, sexual performance or weight loss. All requests to exclude any drug would need to be approved by the Department of Managed Care. The regs are now out for public comment. Top
In Maryland, the Legislature has passed a half a loaf med mal measure that the Governor has threatened to veto because it contained a new tax. One of his platforms he ran on was no new taxes. The State Hospital and Medical Societies have urged the Governor to sign the bill.
As all know President Bush is attempting to get Congress to pass malpractice reform, not only for providers but for pharmaceutical companies as well. It is this plus the trial lawyers having several Republican Senators in their pocket that spells rejection for the plan.
In another blow to the Bush med mal solution is a report commissioned by the administration that stated that malpractice could be contained by stricter management by the state medical boards. Top
In one of the sneakiest tricks the hospital attorneys have ever done is the indirect attack on JCAHO standard MS1.20. During a telephone conference billed as a continuing education event they railed against the standard to such an extent that two unheard of things happened. The first is that the American Health Lawyers Association was so embarrassed to have their conference used as a beard that they offered a refund of the monies paid to attend. The second is that the JCAHO, being the political body that they are and paid by the hospitals, reopened a comment period on the issue. That comment period just ended. I am sure most hospital attorneys have responded but I am not as sure about those who represent physicians and the medical staffs nor the AMA nor the state medical societies. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.